An IUI is performed by introducing a very thin flexible catheter through the
cervix and injecting washed sperm directly into the uterus. The whole process
doesn't take very long and is a fairly painless procedure. Very rarely there is
cramping afterwards.

Where is the sperm collected? How long before the IUI?

The sample is collected through ejaculation into a sterile collection cup in a
collecttion room at PIFC. If you are collecting at home, we require that the
semen be delivered to the office within an hour of ejaculation. After sample is
collected, sperm washing is done and then IUI is done immediately after washing
is over.

Do I have to lie down after an IUI?

We recommend patients lie down on the table for 15 - 30 minutes after the
procedure.

Any precautions to be taken after IUI and for how many days?

Excessive physical exertion to be avoided, other than that no major precautions.
In fact, routine work to continue and sexual intercourse is advised.

Can IUI work after tubal ligation or after tubal blockage?

No. The natural process that leads to pregnancy is having an egg released from a
follicle in the ovary and then beginning the journey to the uterus through the
fallopian tube. Sperm will travel from the vagina, through the cervix, through
the uterus, into the tube where fertilization occurs. So if tubes are
ligated/damaged then fertilization won’t occur. Ideal treatment in such case
will be IVF.

How many cycles of IUI an individual couple can get it done?

3-4 cycles of IUI if Ovarian, seminal and tubal parameters are fine and age of
female partner is<30 with short duration of married life.

FAQs about IVF/ICSI

What is the percentage of success with each treatment cycle?

The possibilities of success with an IVF treatment vary from patient to patient.
Your physician can best predict the outcome in your case after a complete
evaluation. This includes reviewing your history and prior responses to
fertility medications, a thorough physical examination and ultrasound and
drawing up a plan to prepare for your treatment.

What are the side effects of the medications I will be taking?

IVF treatment side effects vary from patient to patient. However, reactions to
medications may include skin irritation at the injection site, abdominal
bloating, headaches, breast tenderness, nausea and leg cramps.

Who will give me the injections?

Nurse(if you visit the centre) or yourself or any family member of yours.

What constitutes day one of my cycle?

First day of full flow is considered the day one of cycle and if the flow has
started in evening then next day is day one. Exceptional circumstances where
there is history of very scanty flow or downregulated cycle where sometimes
there is no menstruation.

How much physical exertion to be done during IVF process?

Controlled physical exertion is advised during IVF cycle like walking and doing
daily household chores but as the IVF treatment cycle progresses, the ovaries
may become enlarged from the fertility medications, and there may be occasional
pain and cramping. Office goers can continue without any disruption in
professional work.

Is the egg retrieval process painful?

No, not generally. It lasts approximately 20 to 30 minutes, and IV
sedation/General anaesthesia is administered so that you will not be awake
during the process. Some patients have mild cramping after the procedure and are
discharged with a prescription for pain medication

Is bed rest recommended after embryo transfer?

No recommendations for bed rest are there. Mental and excessive physical
exertion is to be avoided. Stress free environment and constant support of each
other is required.

When will I be able to tell if I am pregnant?

A blood test is scheduled 10 days(D5 embryo transfer) or 14 days(D2/D3) after
the embryo transfer.

Yes, two embryos are transferred, if both get implanted chances of twins are
there.

FAQs ABOUT PESA/TESA(surgical sperm
retrieval techniques)

1. Are sperm always obtained using PESA/TESA?

Not all patient’s fall into this category,Many a times,no viable sperm is
obtained.Sperms are obtained only if the man’s testicle is producing it.Hormonal
tests and physical examination does help in redicting the response of PESA/TESA
but they are not confirmatory. But definitely,this is an excellent chance for an
azoospermic individual to try ICSI with his own gametes.

2. What if sperms are not obtained?

A proper counseling of couple is done beforehand with transparency and
confidentiality.Couple can undergo donor insemination/ICSI with donor sperms
after informed consent.

3.What happens in PESA/TESA treatment cycle?

The female partner is stimulated similar to IVF cycle and multiple eggs are
obtained. Frozen sperm sample(if PESA/TESA done before) are thawed and used for
ICSI.Or else fresh sperm sample is obtained on the day of oocyte retrieval.

4.Any tests before treatment which can predict success of PESA/TESA?

Hormonal Tests of Male-Very high FSHand LH and very low testosterone indicate an
ill functioning testis and poor prognosis. Physical examination-Very small
testis indicate a poor prognosis. Karyotyping: genetic test of male to indicate
the cause of azoospermia and also the risk to their children. Y-chromosome
deletion-another expensive test which does not alter the course of treatment but
helps is predicting prognosis and risk to their children. CFTR gene- if present
and female partner also has this mutation,the chances that baby may get affected
are high.

5.Postoperative side effects and instructions?

• Mild to moderate pain and discomfort after surgery.
• Day care procedure ,patient is discharged approximately 2 hours post surgery.
• Patient is instructed to wear supportive underwear and and loose trousers till
the discomfort settles.
• There can be slight bruising and infection at the site of surgery(only risk
factors involved)

6.How long can be sperms kept frozen?

As long as 10 years.Patient gives consent and charges for long term freezing. .